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One year after Haiti's devastating earthquake on January 12, 2010, that killed more than two hundred thousand people and left nearly one million homeless, the country remains chaotic and desperate. Exacerbating the continuing challenges of providing adequate food, housing, and clean water following the earthquake are a deadly outbreak of cholera and a contested November 28 presidential election, which have led to renewed debate about how to rebuild the country and usher it into a more prosperous and stable future.

Global health expert Paul Farmer says international aid organizations cannot replace the government and that Haiti's public sector should be strengthened so it can provide for Haitians' needs until the government is able to do it. Brian Concannon Jr., a former election observer in Haiti, argues the United States should insist on new elections because the country needs a credible government to establish stability and rebuild. Beat Rohr, Haiti country director for CARE International, notes the recent flawed process shows that "elections and aid are not silver bullets," and that besides better governance the country needs a number of other things, including successful community-based economic and social development. Robert Maguire at the U.S. Institute of Peace suggests investment in a national civic service corps that puts Haitians to work rebuilding their country.

Paul Farmer, Kolokotrones University Professor and Chair, Department of Global Health and Social Medicine, Harvard Medical School, UN Deputy Special Envoy for Haiti

Relief is not reconstruction. The earthquake was what doctors would refer to as an acute-on-chronic event: a disaster in a setting of profound social precarity. Building back better means adding schools, hospitals, public services--and improving governance. And to do it well, we need to build foreign assistance back better, too: Only 28.8 percent of the donor dollars promised for recovery in 2010-2011 (excluding debt relief) have been disbursed. As much as half of this is eaten up by overhead, never reaching the intended recipients, and the quality of services delivered is too often poor, in spite of best intentions. In no other business would this be acceptable, and we shouldn't accept it either.

We must strengthen the public sector; until the government has resources to provide for the needs of its citizens, Haiti will remain the "republic of NGOs."

Create jobs. Even if reconstruction meant little more than massive job creation, that would be a tremendous step forward. The great majority of the $10.2 billion pledged should be dedicated to giving Haitians decent employment: clearing rubble (only 5 percent has been cleared to date), rebuilding federal buildings (all but one were leveled), and planting trees (Haiti is almost entirely deforested), for example. Fisheries and produce cooperatives generate jobs that also boost local production.

Build decent housing. As many as a million Haitians still live in camps that clog Port-au-Prince's open spaces. Conditions are unsafe and inhumane. But people stay because they have nowhere else to go; the houses they lived in--often as renters in unfavorable conditions--collapsed. Resettlement will require not only decent housing, but also healthcare, education, jobs, and other basic services.

Accompany the public sector. You can't have public health, public education, or public services without a public sector. NGOs like the one I work with cannot replace the government --nor can the United Nations or any other group. We don't have the skills or the mandate, and if aid is to work, it can't fall apart when the expats leave. Although most agree with this principle, less than 1 percent of the more than $2.1 billion in humanitarian aid has flowed to local authorities. We must strengthen the public sector; until the government has resources to provide for the needs of its citizens, Haiti will remain the "republic of NGOs."

Haiti and the global community should lay the foundation for a more stable, prosperous Haiti by running new, inclusive elections with a new, independent electoral council. The current attempts to salvage the disastrous November 28 parliamentary and presidential elections by recounting the votes are like rearranging deck chairs on the Titanic: They will not lead to a result acceptable to the Haitian people, which will imperil both Haiti's recovery from the earthquake and long-term U.S. interests in the region.

Haiti needs a credible government with a popular mandate to establish stability and rebuild. The documented fraud and the subsequent protests that shut down Haiti down for most of December proved that the elections were neither credible nor popular. If the Haitian government and its foreign partners--especially the United States, which contributed $14.5 million, half the election's cost--persist in forcing the results of this election onto reluctant voters, the protests and disruption could continue for the next president's five-year term.

The United States should take leadership in insisting on new elections to protect its investments in Haiti--almost $2 billion spent in 2010 for earthquake response and reconstruction.

The election's problems started long before Election Day, with a stacked electoral council and the improper exclusion of fifteen opposition parties, including Haiti's most popular, Fanmi Lavalas. Turnout was less than 25 percent, and the top three candidates combined received support from 14 percent of registered voters. The solutions to the problems should therefore start at the beginning, with the installation of a new, independent electoral council and the inclusion of all qualified parties.

The United States should take leadership in insisting on new elections to protect its investments in Haiti--almost $2 billion spent in 2010 for earthquake response and reconstruction. Stability in Haiti also reduces the refugee flows that stress our border security and immigration programs, and makes Haiti less hospitable for drug transshipment to the United States.

The "realists" say that there is neither time nor money for new elections. But a few months and $30 million is a small price to pay to avoid wasting five years and the $10 billion promised for earthquake reconstruction. Good elections would also accelerate the departure of the UN peacekeeping mission in Haiti, currently spending $2.5 million per day.

The unresolved November 28 parliamentarian and presidential elections serve as a reminder to both national and international actors that elections and aid are not silver bullets for Haiti's endemic issues. Instead, aid and elections must go hand-in-hand with a sustained commitment to design and implement policies and programs that address the root causes of poverty and inequality in Haiti. Among the principal underlying causes of poverty that threaten Haiti's development and long-term stability are: social exclusion, poor governance, inadequate access to education and other social services, and limited economic opportunities along with environmental degradation.

During its fifty-six years of collaboration with Haiti's impoverished groups, CARE has witnessed that strategies that ignored these factors, their interconnectedness, and the voices of the beneficiaries have always failed to tackle the endemic poverty that has kept the majority of the population vulnerable to natural disasters as well as internal and external shocks, particularly in rural areas.

The Haitian government and the international community need to continue pursuing medium-term development plans to provide urgently needed shelter and improve living conditions for the vast internally displaced population and construct government institutions capable of providing services and stability. But both national actors and donors--including the United States--must also implement a long-term strategy that includes policies and programs with target actions to reduce extreme poverty in Haiti.

Among the principal underlying causes of poverty that threaten Haiti's development and long-term stability are: social exclusion, poor governance, inadequate access to education and other social services, and limited economic opportunities along with environmental degradation.

Through a participatory process, with the goals of ensuring that the needs of Haiti's most vulnerable populations are taken into account, national and international policies must address several critical development needs simultaneously by placing priorities on four deeply interconnected pillars: 1) strengthened democratic governance processes that promote national dialogue and social inclusion; 2) sound economic governance and institutional development at national, regional, and local levels; 3) economic recovery that focuses on job creation in rural and urban settings; 4) build the government's ability to provide access to basic services and social safety nets and protection. Additionally, a successful community-based economic and social development to ensure sustainable livelihoods will require the active engagement of Haiti's private sector.

Robert Maguire, Associate Professor of International Affairs, Trinity Washington University, Chair, Haiti Working Group, U.S. Institute of Peace

After last January's earthquake, "resilience" was used to characterize the strength and courage of Haiti's people. The ability to spring back quickly, however, is a mocking compliment if it becomes an end state. Spring back to . . . what? A year following the earthquake--indeed, as in the decades preceding it--the vast majority of Haitians are stuck in impoverished and desperate conditions, as opportunities for them to improve livelihoods, enhance well-being, and achieve personal growth are lacking. Haiti will become stable and prosperous only after its political and economic elites, and their partners in the international community, find ways of helping the Haitian poor transcend resilience by matching their talents to opportunities and thereby cast off grinding, debilitating poverty.

Haitian government poverty alleviation and economic growth plans in 2007 and 2009, endorsed by international donors, importantly identified decentralized investment in education, healthcare, infrastructure, environmental rehabilitation, and the productive capacity of the long-neglected agrarian economy as keys to stability and prosperity. The government's post-quake recovery and growth plan reemphasized these points, adding a call for decentralized manufacturing, agricultural and tourism "growth poles" as a means of stimulating economic recovery, and improved well-being. International donors responded by pledging close to $10 billion in support of the plan.

A year following the earthquake--indeed, as in the decades preceding it--the vast majority of Haitians are stuck in impoverished and desperate conditions, as opportunities for them to improve livelihoods, enhance well-being, and achieve personal growth are lacking.

So why is Haiti stuck? The problems are myriad and challenges enormous. On the international side, there are the problems of slow disbursements and a continuing approach of unchecked bilateralism that bypasses local and national authorities, inhibits coordination, and maintains a project-by-project approach toward development. On the Haitian side, what's striking is the timid decision-making, continued orientation of elites toward self over country, and the exclusion of poor people's voices in policymaking.

Beyond doubt, decentralization is the key to building Haiti back better. Plans to achieve this, however, not only must address the aforementioned problems, but also must assist people to move beyond resilience. Investment in a New Deal type of national service that puts Haitians to work rebuilding their country could be crucial to transcending resilience and taking strides toward stability and prosperity. It would help Haitians render services to their countrymen and women and gain transferable skills. Also needed are initiatives such as investment credits for small and micro enterprises and conditional cash transfers tied to improved education and healthcare that get money into the hands of the poor.

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